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-. GOILDING PERMIT APPLICATION . . ' <br />APPlic_nt To Complete This form ~! <br />If more than one building is to be contructed, submit a separate permit applica-, <br />Lion for each buil.iing. A separate permit will be issued for eacrh7 building. <br />owner /ire- G. c Building Address �C 1-338�✓�°, LJ. . <br />Address l tS rah CiiK ,>�• rot / Block z <br />city, t Phone l 0 >r� 9 Subdivision (Plat) -" - k �L-e, s- <br />Architect/Engineer <br />"_ = City Phone Metes 6 Bounds (Unplatted) <br />Contractor C <br />•-! �i z � Sec. <br />- TwP- Rge <br />Eddress <br />' City Phone L t.V $ d Ql L Building Use <br />y{ State License Number < <' Describe Work to Be Done <br />a Expiration Date 11 1 % (l <br />SKETCH PLOT PLAN BELOW' <br />I., Use of Building <br />j .. . . <br />New ❑ Addition Q Repair/Remodel <br />• ! _ - •Valuation of Construction $�©- <br />y I• CD <br />PLOT PLAN REQUIRE-HENTS <br />r.. <br />I-1-477—ff— <br />i <br />T <br />� <br />;70T S•:Z <br />Iralicate lot size, name of streets, <br />'indicate location and. width of <br />(� alleys, locate proposed and all <br />_1 !- existing buildings, show distances <br />Ly to property lines, show distances <br />between buildings. <br />Lot size 4 J'Xx % So <br />Lot area Sq. Ft. <br />Si-e of IIlcg. Ea. Ft. <br />Number of Stories <br />Basement <br />Signed By <br />For <br />Owner Phone <br />THIS <br />- Date Raceived 5 S' <br />Plan. Check Number <br />Valua-:on 00j <br />Permit Fee <br />Plan Check Fee <br />Total Fee Due <br />Date Issued `� / L <br />IE-70R CITY USE ONLY <br />U-Le Zone `' „ - l <br />Fire zone_ <br />Occupancy Group-! <br />Type of construction <br />Occupant Load <br />Sprinklers Required _ <br />CITY CFVhFTT <br />A'PPRdVEU FOR �UILIDING PERMIT_ <br />Date.-7i^F3yu.'/ C s-� <br />LX <br />